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There is marked T1 hypointense/T2 hyperintense signal throughout the hemispheric white matter. There is severe white matter loss bilaterally with secondary ex vacuo dilatation of the lateral ventricles (right more than left). The right parietal intraventricular catheter is in the same position with tip at the level of the left frontal horn.
There is a 3 x 5 mm T1 hyperintense/T2 hypointense nodule posterior to the anterior pituitary gland which could represent an incidental Rathke's cleft cyst. The anterior pituitary is prominent, but this could be attributable to the patient's age rather than disease such as an adenoma.
This case is provided as an example of cystic encephalomalacia related to an old vascular insult in the right middle cerebral artery territory.